Rebuilding front teeth that have worn excessively.

This digital smile makeover gives an example of how dental crowns might be used to rebuild and restore the appearance of worn front teeth, even those that have worn extensively.

Case issues and concerns:

1) In this "before" picture, you can see how this person's front teeth, especially his center two, have worn excessively.

We'd suspect that this is an indication that this person has a deep overbite (meaning that his teeth overlap quite a bit). This, combined with a tooth-grinding habit (dentists call this activity "bruxism"), could easily result in the appearance we see in this picture.

If we had another photo taken from a different angle, we would probably see that the lower center teeth (the ones directly under the worn upper teeth) have a beveled biting edge. The idea is that as the lower teeth wear away the uppers (from their backside), the front sides of the lower teeth tend to become more and more beveled.

2) Some of the upper front teeth have white fillings that have deteriorated and stained.

3) In back, on the upper right, this person appears to be missing some back teeth.

  • Significantly worn front teeth.
    Significantly worn front teeth. Significantly worn front teeth.
  • Case after crown placement.
    Significantly worn front teeth. Case after crown placement.
 

Photo submitted by website visitor.

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Treatment solutions:

1) Rebuilding the worn front teeth using crowns. -

Our "after" picture shows how dental crowns might be used to restore the shape and color of the worn upper front teeth, and the misshapen tooth on the lower left. They would be a better choice than dental veneers due to the superior strength characteristics they offer.

2) Repairs for the other teeth. -

A dental bridge or dental implants might be used to replace the missing teeth on the upper right.

For the lower teeth, the treating dentist could even out their biting edges (as shown in our "after" picture) by buffing them down with a dental drill.

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Input from site visitors.

Teeth needed crowns.

My teeth were pretty similar to this. They were worn from the backside and pretty thin at the biting edge. My dentist said veneers wouldn't work. Had to have crowns placed.

teeth crown

Hi sir i lost my half teeth horizontally in accident ...so what is the cost to crown to that teeth..........

Hello Umesh,

We have pages that address the topic of dental costs.

For dental crowns, use this page.

For other costs, start with this listing of procedures.

overbite problems worsening...any help?

Got implants for missing back teeth and four crowns with metal backs for the front teeth. Then two crowns one front and adjacent tooth on the right chipped. Then one front crown #8 and adjacent tooth on left kept getting knocked loose. Now, dentist says root on #8 broke and is so short implant is only thing that can work and every few months I have to get the adjacent tooth on left re-cemented. Need help. Is there a solution?

px

It seems safe enough to simply state that your front teeth are exposed to a greater level of force than they can withstand.

For whatever reason related to the physics involved, some of the forces get focused in a region of some of your crowns (hence they chip), others are absorbed by some crowns as a unit (hence they come off), and then some forces get directed to your teeth and their crowns as a unit (with the root evidently being the weakest link for at least one tooth, hence it has broken).

It's our back teeth that are supposed to bear the highest level of forces. People who don't have back teeth (your previous situation) subsequently shift their chewing activities forward. And as a result they often have problems like you describe because front teeth aren't intended to receive that level of force (constantly and regularly).

Possibly your replacement teeth in back aren't fully functional? (Possibly they don't come into full contact when you close together, hence you still chew with your front teeth? Or possibly the habit of chewing with your front teeth simply still exists?)

Or due to previous tooth shifting and wear (as a result of the loss of your back teeth), when your dentist rebuilt your mouth they "opened" your bite (made the height of your teeth closer to what they were originally) but by an amount that was too great, hence persistent forces are created (and evidently focused on your front teeth)?

Or possibly the excessive forces that exist are due to a habit of tooth clenching and grinding? (A very common scenario.)

For a start, evaluate what your current situation is. Your jaws have a normal "rest" position (teeth fully apart by a fraction of an inch) that they should be in almost all of the time (except when you are eating or at the end of a swallow).

If yours aren't, that's probably where the excessive forces that affect your front teeth come from. (This would be a common scenario with people who clench and grind their teeth.)

If you are at rest position 99% of the time, then the question is why when you eat is such a high level of force directed too your front teeth?

With the first case, you need to quit clenching, or else wear an appliance that can help distribute the forces your habit creates.

With the second case, unless it is the situation where an old habit of chewing with your front teeth simply persists (and can be corrected), your dentist will have to figure things out.

Disadvantaged of using tooth caps

hello sir..I have a similar problem..my teeth alignment is not properly wellshaped..teeth filling is reauired and also one teeth is missing...so plz suggest me..which thing is benifited for me..if u want the picture of my teeth..den i ll give it u..reply..

Rupa

This link explains general reasons why crowns are placed (as opposed to fillings).
And this link provides additional information about the pros and cons of fillings vs. dental crowns.

But it's really only your dentist, after having examined your teeth, who has all of the information needed to help you decide between the two.

Then once your teeth have been rebuilt (and replaced in your case), you'll need to take steps to prevent future wear from occurring. It's very common for a dentist to have their patient wear a "night guard" appliance to help to prevent wear while they sleep. During the day you'll need to make a conscious effort not to grind your teeth so no more damage occurs.

Crowns following bruxism

Hi
My upper front teeth are worn and chipped, plus worn to the dentine at the rear due to Bruxism. I have no missing teeth, just fillings and crowns.
I am over 70 and my father is almost 100.
I can supply a picture if needed but the wear is slightly worse than the example on this page, the upper middle teeth being worn more. I always had small teeth.
My dentist advises that I would need crowns on bottom back teeth in order to avoid undue pressure and fracture risk on the top front, if they were crowned. Alternatively he has suggested leaving the current teeth for 10 years, subject to annual review.
I have been wearing a night guard for about 10 years and consciously try to avoid clenching or grinding during the day.
Given the issues that can arrive with crowns I lean to the latter option, but wonder how to weigh up the risks of not doing anything now.
Only 1 of my 4 bottom back teeth appears to be a crown. I wonder too whether only crowning the front teeth with limited extensions would be possible as one of your pages seems to suggest, despite my dentist's above comment.
Can you please advise my best options and their benefits, including any not covered above? A cosmetic improvement would certainly be welcome, but not essential to me.

Keith

We're guessing that due to the amount of wear your teeth have undergone your dentist feels that they need more available space/clearance in order to place upper front crowns.

This would have to do with where your upper and lower front teeth touch. When placing a crown, the tooth needs to be trimmed a certain amount to accommodate its thickness. We would think that your dentist feels that doing so might expose the nerve of your teeth, or else result in tooth nubs so short that the crowns wouldn't stay in place well.

As a solution a dentist will "open the patient's bite." They do this by making the back teeth taller (hence the crowns you mention) so there is more clearance available (front-tooth separation). That way the front teeth don't have to be trimmed so much to accommodate the crowns' thickness.

We get your longevity point. We would also mention that if a person's bruxism is not controlled that placing crowns may offer some benefits short-term but over the long-term will fail and/or cause problems (such as wear) with other teeth.

You seem motivated in your attempts to control your bruxism. And if you were 100% successful the concerns about future wear with or without crowns would be drastically reduced.

You don't mention how successful your efforts seem to have been over the last 10 years. If there are still some issues, have you considered including some daytime use of you guard to further reduce the level of wear that is occurring?

Only you and your dentist can make a decision about your treatment. If aesthetics aren't a big factor and further wear isn't occurring at a great rate, not placing crowns means less expense, less maintenance of restorations (crowns can come off, break, need replacement), usually it's easier to brush and floss natural teeth (thus reducing potential for gum disease), opening a person's bite can cause TMJ problems/issues, crowns that are not polished well can cause extensive wear of opposing teeth with bruxers, when heavy bruxing forces are involved porcelain crowns can break, crown wear can occur in bruxers. Ask your dentist but it seems naive to think that within the next 30 years of your life that this work wouldn't need serious maintenance or outright replacement.

Obviously this isn't an easy choice. Clearly everything depends on the level of bruxing activity that can be expected to continue. Good luck.

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